| NPI | 1497771349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA BERNA Pharmacy Director PIC 602-256-9323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: AZ YO4257) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2025-09-11 |